| Doctor Name: | JAMES CORNELIUS |
| NPI Number: | 1346547510 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CADC |
| License Number: | 09-P-15 |
| Business Practice Address: | 2013 1st St Baker City, OR - 978143339 |
| Business Phone Number: | 5415233841 |
| Business Fax Number: | 5415233841 |
| Mailing Address: | 2013 1st St, BAKER CITY |
| State: | OR |
| Postal Code: | 978143339 |
| Phone Number: | 5415233841 |
| Fax Number: | 5415233841 |
| NPI Enumeration Date: | 02/23/2011 |
| NPI Last Update Date: | 02/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 09-P-15 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |